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‘ALWAYS KEEP THE label’ is a mantra that sticks out most this crazy time of year, in case you need to exchange any malfunctioning toy or oversized jumper come New Year.

And that’s a practical thing to do. Keeping the labels.

However, not every label comes with a gift. Bipolar disorder. Personality disorder. Schizophrenia. Depression. Dementia. All labels, like cancer, like diabetes. More curse than gift every illness invariably takes away dignity, self-worth, sense of control – everything slips or is slowly stripped away.

We like to believe the analogy, the myth, that each and every label hangs indiscriminately from the same social rack – but in reality they don’t. A doctor will readily diagnose cancer or diabetes if investigative blood tests and MRI scans detect same. Promptly followed is a treatment plan and a person is giving a fighting chance of being cured.

At the other end of the diagnostic spectrum comes mental illness. And that fighting chance not so forthcoming because of the age old debate of whether to diagnose or not, because we’re dealing with damaged goods and a faulty label – that reads both bold and clear – ‘stigma’. So what do we do?

Stigmatising the stigma

We stigmatise the stigma – by either not diagnosing someone with a mental illness or reluctantly doing so when the illness is proving perilous to a person’s life. The proper analogy is that if stigma were cited as the reason for a doctor withholding a cancer or diabetes diagnosis from a patient, thwarting the chance to avail of life-saving treatment – he would undoubtedly be brought before The Irish Medical Council.

Regardless of stigma and condition, everyone should be afforded the same autonomy. Learning that you have a mental illness for the first time is a hard pill to swallow but not as hard as learning that your health records predated the fact and nobody thought to tell you. And had you known of the diagnosis the treatment sought thereafter would have proven life-changing and at times life-saving.

The psychiatrist concurs but counteracts with the reality that decisions are made in the best interests of patients and that sometimes remaining ignorant of a diagnosis is the lesser of two evils, with stigma remaining as the darker force. You still disagree because knowing the workings of your own mind and putting it at rest is more important than stigma.

People who live with a mental illness don’t have the luxury, much less care for endless ethical and non-appreciative debates on – ‘to label or not to label’. If a label helps a person stand outside of themselves, steal one moment of freedom from a lifetime of self-persecution, confusion and shame, then being given that label is more than a good thing. It’s a humane thing.

It doesn’t mean having to wear the label forever, but just long enough to access the appropriate treatment and slay that inner nagging demon that always telling you that there is something seriously wrong with you and that it’s all your fault.

Overwhelming relief

What’s underestimated is the overwhelming relief people feel when they get a mental illness diagnosis. Ironically, it can be for the first time in their life they feel anyway normal. But society chooses its own norms. Traditions.

Christmas isn’t a box of roses for a lot of families and many become estranged because of mental health issues and alcoholism. And as helpful as a diagnosis can be (in accessing treatment and learning self-compassion) it can have a negative impact on the family status quo, the perfected mask and the habitual scapegoating. Many might crave spending Christmas dinner with family but decide not to as being the healthier option.

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